Intralymphatic immunotherapy in allergic rhinitis shows improvement of subjective symptoms and induction of immune tolerance, especially for grass pollen allergens and mixed allergens. The systematic review and meta-analyses assessed the quality of the evidence, with 6 results being of high quality, 13 of moderate quality, 18 of low quality and 27 of very low quality. The assessment of the risk of bias was low, but the methodological quality of the studies was predominantly low. The safety profile of intralymphatic immunotherapy was favorable, with mostly mild local adverse effects and fewer systemic reactions compared with conventional subcutaneous immunotherapy. The treatment has acceptable short- to medium-term results, but its long-term effectiveness is limited. The authors recommend future studies following established guidelines to obtain better quality evidence. The system overview was registered on PROSPERO under the number CRD420251126501.